| Description |
The difference in satisfaction of consumers receiving prenatal care at three low-income clinics in Salt Lake City was investigated. Fifty-two subjects were selected based on criteria which included age, income, gestation, and number of clinic visits. Twenty-two subjects participated from the Maternal and Infant Care Clinic (M and I), while 15 each participated from the Obstetrical Resident Clinic (OBR) and the Nurse-Midwifery Clinic (NMW). The clinics represent different mixes of primary care providers with the M and I staffed by a multidisciplinary team, the OBR by first and second year obstetrical residents from the University of Utah, and the NMW staffed by certified nurse-midwives from the faculty and first year nurse-midwifery students at the University of Utah. Data were collected from May to October of 1976. Questionnaires were administered to patients, meeting the selection criteria, as they waited for their clinic appointments. The questionnaires contained 20 satisfaction statements, 11 knowledge statements, 10 demographic data questions and provided for an open-ended response. Clinic charts were screened to develop the care rendered score. The subject's hospital chart was reviewed after delivery to determine the outcome score. Thus, four scores were obtained: satisfaction, knowledge, care rendered and outcome. Analyses of cross-tabulations of clinics by parity, education, present of a support person, reasons for choosing the clinic, attendance at prenatal classes, and total income using Chi Square showed no differences. Between clinics were found for marital status, religion, and source of health care payment. There were more single subjects in the M and I Clinic (M and I, 21.2%; OBR 0.0%; NMW, 5.8%), more third party payments in the M and I Clinics (insurance: M and I (9.6%), OBR (3.8%), NMW (1.9%); welfare: M and I (13.5%), NMW (0.0%); and, variations in the religious preference of subject attending each clinic Mormon (19.2% from each clinic); Catholic: M and I (11.5%), OBR (3.8%), NMW (0.0%); no religious preference: M and I (9.6%0, OBR (5.8%), NMW (9.6%). Clinic mean scores for age, care rendered, patient knowledge, patient outcome and patient satisfaction were subjected to analysis of variance and no differences were found between clinics in regard to care rendered (P >.05), patient knowledge (P > .05), and patient outcome (P > .05). There were significant differences in age (P<.01) and satisfaction scores (P <.001), The Newman-Keuls Multiple Range Test applied to the age data identified a difference between the M and I and NMW Clinics, but no differences between either the M and I and the OBR and the NMW Clinics. This same analysis was applied to satisfaction scores and differences were detected between all three clinics. These findings, in which there was a significant difference in satisfaction scores did not support the null hypothesis which stated there would be no difference in satisfaction scores among three low income prenatal clinics in Salt Lake City. The fact that the M and I Clinic (multidisciplinary approach) received the highest mean score for satisfaction (M and I, 26.31; OBR, 13.0; NMW, 21.53) supports the findings of earlier studies which indicate that it is difficult for any one primary health care provider to meet the needs of a pregnant adolescent population (Fielding & Nelson, 1973). The wide difference in satisfaction scores between the OBR and NMW Clinics was of extreme interest due to the fact that they utilize the same facilities and the same ancillary personnel, differing only in that they are held on different days of the week. The major difference is the nature of the primary provider: Obstetrical residents versus nurse-midwives. Analysis of individual satisfaction questions found the M and I and NMW Clinics scoring much higher than the OBT Clinic in those questions which related to provider-consumer interaction. |
